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#Executive summary
On the topic of virtual care, health system decision-makers have more questions than answers. This report explores the current landscape of Canadian virtual care data and information. It includes a snapshot of available virtual care data from the Canadian Institute for Health Information (CIHI), the provinces and territories, and pan-Canadian health care organizations. It also recommends new areas of pan-Canadian focus for measuring the quality and accessibility of virtual care.
Many jurisdictions delivered services virtually before the COVID-19 pandemic began, though the type and coverage of virtual care offerings depended on geography, population characteristics and investment priorities. In 2020–2021, provincial and territorial governments signed bilateral agreements with the Government of Canada to support new investments in virtual care. These agreements allowed the jurisdictions to apply new funds to local priorities, leading to a range of natural experiments across the country. Provincial and territorial governments have provided CIHI with baseline data to help describe the progress that will be made with these investments and to help lay the foundation of what we do and do not know about virtual care.
To help address these information gaps, CIHI conducted literature scans and consulted with patients, the public, clinicians and health system decision-makers to identify a small set of indicators to enable public reporting on the progress of virtual care implementation and broader health system outcomes. CIHI recommends the following indicators be tracked over time:
- Potentially Avoidable Visits to the Emergency Department;
- Appropriateness of the Modality (Patient-Reported and Provider-Reported);
- Wait Times for Community Mental Health Counselling; and
- Access to Virtual Care for Underserved Populations.
For jurisdictions with the capacity to collect or expand the collection of patient-reported experience measures (PREMs) for virtual care, CIHI also recommends the following measures:
Communication With Provider;
- Respect and Cultural Safety;
- Patient Choice Regarding the Modality of Their Visit; and
- Patient Use of Virtual Care — Overall Experience.
Longer-term goals include having high-quality standardized data from across care settings and robust indicators to track progress over time. We still need more cross-sectoral data so health care can be examined as a process (that includes virtual modalities) rather than as a transaction at a single point in time. There is also a need to understand privately delivered virtual health care services. In the meantime, we can leverage new standards and early analytical work recently developed by CIHI and included in this report. If we are to help ensure that virtual care is accessible to all Canadians, we need to think about the breadth and depth of data required — to better understand the appropriateness of care, patient experiences and value for money around virtual care implementation. CIHI would be pleased to continue working with health system planners, patients and providers to better grasp the state of virtual health care, and ultimately to design and manage more effective services and delivery models to meet the needs of Canadians.